Loading...
Homestead_East H. PREPARER Preparer of the Sales Disclosure Form Title Sandra L. Hicks Attorney Company Address(number and street,city,state,country,and ZIP Code) 102 N. Elm Street, Fort Branch, IN 47648 I. SELLER(S)/GRANTOR(S) Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance document Allen L. Bates Address(number and street) Address(number and street) 1971 ESR68 h .4, City,State,and ZIP Code City,State,and ZIP Code Haubstadt, IN 47639 Country Country 8€0 ..6 .) USA Gibson o Email Address ( of my knowledge and 6 true, orrect,and com as required by law,and Is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intenti�iC Ufa ies the value of t anbfer?b(! real property,or omits or falsifies any informatii required to be provided,commits a Level 5 felony. YY.y Signature of S er. /1 ) Signature of Seller �U/�, 0, Printed Name of Seller Date Signed(mm dd/yyyy) Printed Name e of Seller Date Signed(mm/dd/yyyy Allen L. Bates 07/26/2023 J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY Buyer 1 -Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document Jeremy M. East Joslynn M. East Address(number and street) Address(number and street) 1012 S. Main Street 1012 S. Main Street City,State,and ZIP Code City,State,and ZIP Code Fort Branch, IN 47648 Fort Branch, IN 47648 Country Country USA Gibson USA Gibson Email Address YES NO CONDITION YES NO CONDITION O 1.Will this property be the buyer's primary D 0 3. Homestead residence? 0 © 4.Solar Energy Heating or Cooling System O D 2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device for this residence? If yes, provide address: 0 lB 6. Hydroelectric Power Device Address(number and street) 0 O 7.Geothermal Energy Heating or Cooling Device City,State,and ZIP Code County a6-'lg - -toy—000 ntL1-d2C . Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct,and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's Information,SSN/Drlver's License/ID/Other Number is necessary only if a Homestead Deduction is being filed.) Page 3 : -'` ir,. +-. _ ..--, I`ND1^ A CERTIFICATE- E40F TITLE t.. - ,-----= = ,L. r�, ,i it DO NOT"ACCEPT TITLE SHOWING ANY ERASURES,ALTERATIONS OR R MUTILATIONS `"-r^"' NO ADDITIONAL RE—ASSIGNMENTS PERMITTED